Sasaki O, Nagahama S, Kusano T, Soejima K
Dept. of Surgery, Fukuoka Dental College, Japan.
Gan To Kagaku Ryoho. 1996 Jun;23 Suppl 2:125-9.
Surgically resected specimens of 139 cases of large-bowel carcinoma were analysed in this study. Each carcinoma was cut out in stepwise section through the whole tumor, and flow cytometric DNA measurement was performed for each section. The intratumor DNA ploidy distribution pattern decided in this way was classified into 5 types (Type A-E). The 139 cases of carcinoma comprised 19 cases of Type A, 27 Type B, 11 Type C, 37 Type D and 45 Type E. The intratumor DNA ploidy distribution pattern showed a statistically significant correlation to tumor size, gross type, depth of invasion, growth pattern at the tumor margin, venous permeation of visceral wall, DNA Index and Dukes stage. Among these 5 types of carcinoma, carcinoma showing Type E was seen most frequently, even in the earlier stage, and found most frequently among the cases showing invasive growth pattern at the tumor margin, positive venous permeation in the visceral wall and DNA Index of more than 1.7. Therefore, the intratumor DNA ploidy distribution pattern seemed to reflect the degree of tumor malignancy as well as that of tumor advancement. Moreover, Type E pattern of carcinoma appeared to reveal the highest grade of malignancy, and early detection of this type seemed to be necessary in order to improve survival after surgery.
本研究分析了139例手术切除的大肠癌标本。每例癌组织均通过整个肿瘤进行逐步切片,对每片进行流式细胞术DNA测量。以此确定的肿瘤内DNA倍体分布模式分为5种类型(A - E型)。139例癌组织中,A型19例,B型27例,C型11例,D型37例,E型45例。肿瘤内DNA倍体分布模式与肿瘤大小、大体类型、浸润深度、肿瘤边缘生长方式、脏壁静脉浸润、DNA指数和Dukes分期具有统计学显著相关性。在这5种类型的癌中,E型癌即使在早期也最常见,在肿瘤边缘呈浸润性生长方式、脏壁静脉浸润阳性且DNA指数大于1.7的病例中最为常见。因此,肿瘤内DNA倍体分布模式似乎反映了肿瘤的恶性程度以及肿瘤进展程度。此外,E型癌似乎显示出最高的恶性等级,早期发现这种类型似乎对于提高手术后的生存率是必要的。